Individual
RIICHI ANDRE OTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
971 LAKELAND DR STE 557, JACKSON, MS 39216-4661
(601) 200-4560
(601) 200-4580
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(601) 200-4560
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
36082
LA
2084N0400X
Neurology Physician
A194002
CA
Other
Enumeration date
05/21/2020
Last updated
10/15/2025
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